Building a Better Joint

12/22/2015By Saint Barnabas Medical Center

A robotic system makes hip and knee replacement surgery better than ever.

Joint replacement surgery has gone mainstream. In recent years, new surgical
techniques and better prosthetics have allowed ever younger individuals
to maintain their active lifestyles by replacing worn-out knees and hips.
Indeed, about 1 million knee and hip replacements are performed each year,
and nearly 5 million people are now living with an artificial joint.

Now joint replacement has gone robotic too, thanks to a new technology
called MAKOplasty. Michael Rieber, M.D., an orthopedic surgeon at Saint
Barnabas Medical Center, says this robotic surgical system makes a good
procedure even better. “Joint replacement has been touted as one
of the greatest medical advancements of the late 20th century, and now
the robot makes it more precise, leading to a quicker recovery and longer-lasting
replacement,” he says.

MAKOplasty is currently approved for partial knee replacement—in
which only the diseased and damaged portion of the joint is replaced—and
total hip replacement procedures. It uses three-dimensional computed tomography
(CT) imaging to determine the precise implant size, position and alignment
for each patient, and it helps the surgeon accurately map the areas of
bone and soft tissues that need to be removed. During surgery, a robotic
arm is partially controlled by software to help follow that map. “It
won’t let you go where it is not programmed to go,” Dr. Rieber says.

For partial knee replacements, this helps preserve healthy tissue and ligaments.
“With this approach, the knee is better balanced for a normal arc
of motion,” he says. “That means there will be less pain,
because the position of the implant is optimized. Patients recover better
and have a more natural-feeling knee.”

In total hip replacement, MAKOplasty increases the accuracy of implant
placement, which reduces the potential for complications. “Sometimes
there are problems with uneven limb length and with dislocation, but there
are so many data points and so much information with the robotic system,
it reduces the likelihood of any limb inequalities or dislocation,”
says Dr. Rieber.

He adds that the Food and Drug Administration recently approved the software
and procedure for total knee replacement with the robot. “That’s
really exciting,” he says. “We don’t do that many partial
knees, and the total knee will be launched in the next few months here
at Saint Barnabas. We will be one of the first in the area to do it robotically.”

Robotic replacement surgery is “good for all comers,” he says,
with the possible exception of patients seeking a revision of an existing
implant. “It is a great tool to have,” the doctor adds. “It
gives surgeons and patients more confidence. Everybody wins.”

To find out more about joint replacement procedures using MAKOPlasty at
Saint Barnabas Medical Center, please call 973.322.9908 or visit
barnabashealth.org/sbmcmakoplasty.